The relationships among depression, withdrawal symptoms and compulsion among heroin abuser with methadone replacement treatment in Taiwan
Kun-Hua Lee and Cheng-Fang Yen
Yuli Hospital, Taiwan
National Dong Hwa University, Taiwan
Kaohsiung Medical University Chung-Ho Memorial Hospital, Taiwan
: J Addict Behav Ther Rehabil
Abstract
Introduction: Literature indicated depression could be a significant predictor of withdrawal symptoms. Then, people could compulsively seek and use more heroins in order to improve withdrawal symptoms. Despite evidence proved these relationships among depression, withdrawal symptoms and compulsion on heroin abusers, little study proposed hypothesized model and comprehensively examined the relationships among these factors. Furthermore, the present study proposed a hypothesized model of depression, withdrawal symptoms and compulsion (DWC model) and examined the hypothesized model by heroin abusers with methadone replacement treatment. Methods: Cross-sectional study was conducted to examine the hypothesized model. Two hundred and thirty five participants were recruited from the inpatient of methadone replacement treatment in Southern Taiwan. After informed consent, all participants were asked to complete the questionnaires in terms of depression, compulsion to use heroin, the severity of withdrawal symptoms and daily consumption of heroin use. Descriptive analyses were to present the distributions of demographic variables. Structural Equation Modeling (SEM) was to examine the model-of-fitness indices of the DWC model. The significant level was at 0.5. Results: Our results found full DWC model showed good model-of-fitness indices (X2=1.61; df=48, p<0.05; CFI=0.98; RMSEA=0.05). However, the relationship between depression and use of heroin did not reach significant level. After deleting insignificant relationship, the reduced DWC model showed proper model-of-fitness indices (X2=1.68; df=50, p<0.05; CFI=0.97; RMSEA=0.05). Through Sobel Test, compulsion to use not only played as mediated role between depression and use of heroin, but also mediated the relationship between withdrawal symptoms and use of heroin. Discussion: Despite depression and withdrawal symptoms are significant predictors of use of heroin, compulsion to use plays as a crucial role for taking heroin. Moreover, the patients with heroin use disorder could be treated to decrease consumption of heroin in terms of behavioral modification on compulsively drug taking, for example, mindfulness-based training. By mean of mindfulnessbased training, people with heroin use disorders could be taught to non-judgmentally and objectively accept the urge of compulsively taking drugs. Further study could pay more attention on the effectiveness of mindfulness-based training on heroin use disorder.
Biography
Kun-Hua Lee is a certified Clinical Psychologist in the Department of Clinical Psychology from Yuli Hospital, Ministry of Health and Welfare. He did his PhD in the Department of Counseling and Clinical Psychology from National Dong Hwa University. His research interest is mainly on Clinical Psychology, Psychology, Health Psychology, Applied Psychology, Medical & Health Profession Education, Psychotherapy, Cognitive Behavioral Therapy, and Evolutionary Clinical Psychology.
Email: kunhualee627@gmail.com
